Education provided by occupational therapists in applying joint protection techniques will reduce stress on involved joints, and allow the individual with OA to perform daily activities with less pain.
Together, the patient and therapist can address difficult and painful activities so these can be performed more easily by the use of an alternative technique, use of an assistive device, or with the support of a splint. Using two hands for activities, using tools with large handles, and using the entire body to perform tasks are examples of techniques to reduce stress on the wrists and hands.
Instruction in range-of-motion exercises along with strengthening of the extrinsic and intrinsic muscles of the hand will help to prevent deformities and facilitate the ability to perform activities requiring grip and pinch. Range-of-motion exercises should emphasize abduction of the thumb to counteract the adduction posturing, and ensure the flexibility of the interphalangeal joints for grasp and manipulation of various sized objects. Hand strengthening can be achieved with the use of soft putty and correct exercises taught by the therapist.
Patient education is the key to self management. Rheumatology health professionals can help patients learn more about OA and other rheumatic diseases, medications, and topics by providing access to ACR Patient Fact Sheets, which can be downloaded by visiting www.rheumatology.org and clicking on “Patient Resources” under “Popular Content.”
Carole Dodge is an occupational therapist and certified hand therapist at the University of Michigan Hospital and Health Systems in Ann Arbor.
